Common cancer treatments do not worsen COVID-19 infection, study finds

A study has found that chemotherapy and surgery do not correlate with worse COVID-19 outcomes for cancer patients, whereas taking immune checkpoint inhibitors does.

Cancer and COVID-19

A team of researchers at Memorial Sloan Kettering Cancer Center (MSK), US, has reported on the epidemiology of COVID-19 illness experienced at an NCI-designated cancer centre during the height of pandemic in New York City.

According to the study, patients in active cancer treatment who develop COVID-19 infection do not fare any worse than other hospitalised patients. Notably, metastatic disease, recent chemotherapy or major surgery within the previous 30 days did not show a significant association with either hospitalisation or severe respiratory illness due to COVID-19. However, they did find that some kinds of immunotherapy do correlate with worse outcomes. 

The researchers say their findings suggest that generally, no patients should delay cancer treatment because of concerns about the virus.

“If you’re an oncologist and you are trying to figure out whether to give patients chemotherapy or if you’re a patient who needs treatment, these findings should be very reassuring,” says Dr Ying Taur, an Infectious Disease Specialist at MSK.

The study investigated 423 patients at MSK diagnosed with COVID-19 between 10 March and 7 April. Overall, 40 percent were hospitalised for COVID-19 and 20 percent developed severe respiratory illness. About nine percent had to be placed on a mechanical ventilator and 12 percent died. The most frequent cancer types included solid tumours such as breast, colorectal and lung cancer. Lymphoma was the most common haematologic malignancy. Over half of the cases were metastatic solid tumours, the researchers say.

Similar to other studies in the general population, the researchers found that age, race, cardiac disease, hypertension and chronic kidney disease correlated with severe outcomes. The investigators found that patients taking immunotherapy drugs called immune checkpoint inhibitors were more likely to develop severe disease and require hospitalisation. The team note that further research is required to look at the effects of these drugs. However, other cancer treatments, including chemotherapy and surgery, did not contribute to worse outcomes.

“The course and clinical spectrum of this disease is still not fully understood and this is just one of many studies that will need to be done on the connections between cancer and COVID-19,” explained Dr Mini Kamboj, Chief Medical Epidemiologist, Infection Control at MSK. “But the big message now is clear: people should not stop or postpone cancer treatment.”

The results were published in Nature Medicine.